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CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(08): E955-E963
DOI: 10.1055/a-0903-2565
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Comparison of tissue and molecular yield between fine-needle biopsy (FNB) and fine-needle aspiration (FNA): a randomized study

Ravishankar Asokkumar
1   Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
,
Chin Yung Ka
1   Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
,
Tracy Loh
2   Department of Anatomical Pathology, Singapore General Hospital, Singapore
,
Lim Kah Ling
3   Department of Molecular Pathology, Translational Pathology Center, Singapore General Hospital, Singapore
,
Tan Gek San
2   Department of Anatomical Pathology, Singapore General Hospital, Singapore
,
Hao Ying
4   Health Service Research Unit, Singapore General Hospital, Singapore
,
Damien Tan
1   Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
,
Christopher Khor
1   Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
,
Tony Lim
2   Department of Anatomical Pathology, Singapore General Hospital, Singapore
,
Roy Soetikno
1   Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
5   Duke-NUS Graduate Medical School, Singapore
› Author AffiliationsTRIAL REGISTRATION: Single center, prospective, randomized crossover trial NCT03109639 at clinicaltrials.gov
Further Information

Publication History

submitted 11 December 2018

accepted after revision 18 March 2019

Publication Date:
24 July 2019 (online)

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Abstract

Background and study aims Recently, a new Franseen design endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) needle was developed with the goal of providing more tissue for histology. We compared the tissue adequacy rate and nucleic acid yield of 22G EUS-FNB vs. 22G endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), in solid gastrointestinal and extra-intestinal lesions.

Patients and methods We conducted a randomized crossover study and recruited 36 patients. We performed three passes for pancreatic lesions and two passes for other lesions, using each needle. We blinded the pathologist to needle assignment. We assessed the diagnostic tissue adequacy rate and compared the total tissue area, diagnostic tissue area, and desmoplastic stroma (DS) area in cases of carcinoma. We also examined the nucleic acid yield of the two needles in pancreatic lesions.

Results The lesions included 20 pancreatic masses (55 %), six gastric subepithelial lesions (17 %), five lymph nodes (14 %) and five other abdominal masses (14 %). Mean ± SD lesion size was 3.8 ± 2.0 cm. The final diagnosis was malignant in 27 lesions (75 %) and benign in nine lesions (25 %). We found EUS-FNB procured significantly more median total tissue area (5.2 mm2 vs. 1.9 mm2, P < 0.001), diagnostic tissue area (2.2 mm2 vs. 0.9 mm2, P = 0.029), and DS area (2 mm2 vs. 0.1 mm2, P = 0.001) in lesions diagnosed as carcinoma (n = 23), as compared to EUS-FNA. In pancreatic lesions, EUS-FNB obtained significantly more nucleic acid than EUS-FNA (median; 4,085 ng vs. 2912 ng, P = 0.02). There was no difference in the cellblock or rapid on-site cytological evaluation (ROSE) diagnostic yield between the needles.

Conclusion The 22G EUS-FNB provides more histological core tissue and adequate nucleic acid yield compared to 22G EUS-FNA. In this study, the diagnostic performance was similar between the needles

 

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